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Top Carers Nursing and Domiciliary Care Agency Requires improvement

Inspection Summary

Overall summary & rating

Requires improvement

Updated 14 August 2021

About the service

Top Carers Nursing and Domiciliary Care Agency is a domiciliary and nursing care service. The service provides personal and nursing care to people living in their own homes. At the time of the inspection eight people were receiving personal care and no people received nursing care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection some people were receiving support which did not include personal care and the provider also supplied staff to care homes and hospitals. We did not review the care they received as it is outside our regulatory remit.

People’s experience of using this service and what we found

The provider had assessed risks to people to ensure staff had clear guidance to follow when caring for people but assessments relating to medicines management were not sufficiently comprehensive. The provider could not evidence they always checked medicines records regularly to ensure people received their medicines as prescribed. The provider told us they trained and assessed staff as competent to administer medicines but these checks were not always recorded to ensure a clear record of any areas where staff required more support. Staff received regular supervision but this was not recorded to ensure a record of support as required by law. Our inspection findings showed the provider’s system of audits and checks required improvement as they had not identified and resolved the concerns we identified.

The provider checked staff were suitable to work with people through recruitment checks, although they did not always investigate gaps in employment records. There were enough staff to support people safely and staff timekeeping was good. Staff followed suitable infection control practices, including the safe use of personal protective equipment (PPE) to reduce the risk of COVID19 transmission, and received training on this.

Staff received suitable training and support on how to meet people’s needs. People were supported to maintain their health and staff were trained to meet people’s specific needs, such as those relating to epilepsy and breathing equipment. People received food and drink of their choice. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and their relatives were very positive about the staff who supported them and developed good relationships with them. People received consistency of care from staff who knew them well. Staff treated people with dignity and respect. People were involved in their care and their care plan was based on their individual needs and preferences. The provider had a suitable complaints procedure in place and relatives had confidence any complaint would be investigated properly.

A registered manager was in post who was supported by a contracts officer, office manager and a senior nurse who also trained staff in specialist topics. Staff felt well supported by the management team. Relatives and staff told us the service was well-led and the provider engaged well with them.

For more details, please see the full report which is on the CQC website at

Rating at last inspection

This service was rated Good at our inspection in March 2015.

Why we inspected

This inspection was prompted because of the length of time since our previous inspection. We needed to check whether the service was meeting people’s needs.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Inspection areas


Requires improvement

Updated 14 August 2021

The service was not always safe.

Details are in our safe findings below.


Requires improvement

Updated 14 August 2021

The service was not always effective.

Details are in our effective findings below.



Updated 14 August 2021

The service was caring.

Details are in our caring findings below.


Requires improvement

Updated 14 August 2021

The service was not always responsive.

Details are in our responsive findings below.


Requires improvement

Updated 14 August 2021

The service was not always well-led.

Details are in our well-led findings below.